Provider Demographics
NPI:1396001889
Name:NEW LIFE ADULT SOCIAL DAY CARE
Entity Type:Organization
Organization Name:NEW LIFE ADULT SOCIAL DAY CARE
Other - Org Name:NEW LIFE ADULT DAYCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHNABEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TRIPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-253-5658
Mailing Address - Street 1:727 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3624
Mailing Address - Country:US
Mailing Address - Phone:732-253-5658
Mailing Address - Fax:732-325-0860
Practice Address - Street 1:727 FRANKLIN BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3624
Practice Address - Country:US
Practice Address - Phone:732-253-5658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0666106Medicaid